New lung ultrasound can assess cancer without surgery

Harriet Byers, R.N., has been a nurse for 35 years, but she still gets excited when a new procedure comes along to benefit patients.

The endoscopic bronchial ultrasound, now offered at Western Baptist Hospital, provides a precise lung cancer diagnosis without surgery. Before this new technology, doctors could only approximate the location of lymph nodes for needle aspirate samples with a 40 percent accuracy rate.

“When you get a new procedure that you know really helps patients, that’s what it is all about,” said Byers, coordinator for the Center of Digestive and Pulmonary Health at Western Baptist.

Endobronchial ultrasound can assess a patient’s lymph nodes and determine if lung cancer has spread to other parts of the body.

Pulmonary medicine physician Keith Kelly, M.D., said patients with lung cancer may avoid more complicated surgery because this technique accurately shows the cancer stage.

He performed the first endobronchial ultrasound procedure at Western Baptist in late February.

“What this does is increase our ability to correctly diagnose and stage malignancies and other diseases involving the chest without having to resort to surgery to do it,” Dr. Kelly said.

During the ultrasound, the patient is under general anesthesia while a small bronchoscope is passed into the windpipe. The scope has a small instrument at its tip which can point in different directions to show lymph nodes and other structures in the area between the lungs.

Using the probe’s detailed images, the physician is able to assess whether the cancer has spread by looking in areas of the chest where it’s traditionally difficult to biopsy. If suspicious areas are seen – such as enlarged lymph nodes – a hollow needle can be passed through the bronchoscope and guided by ultrasound into the abnormal structures to obtain an aspiration biopsy.

This innovation is the latest advancement in Western Baptist’s cancer care, which is accredited by the American College of Surgeons Commission on Cancer. It has received the commission’s Outstanding Achievement Award for two consecutive three-year cycles for achieving standards met by just 5 percent of the nation’s hospitals.